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<title>Registration</title>
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<div id="topnav">
<!--Register | About | Login-->
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<h1> New Users Please Register to Vote</h1>
<br />
<br />
<FORM METHOD=POST ACTION="Registration">
<TABLE BORDER=0>
<TR>
<TD>User Name: </TD>
<TD><INPUT TYPE=TEXT NAME=username SIZE="20"></TD>
</TR>
<TR>
<td>Password: </td>
<td><INPUT TYPE=PASSWORD NAME=password SIZE="20"></td>
</TR>
<tr>
<td>Confirm Password: </td>
<td><INPUT TYPE=PASSWORD NAME=confirmpassword SIZE="20"></td>
</tr>
<tr>
<td>Full Name: </td>
<td><INPUT TYPE=TEXT NAME=name SIZE="20"></td>
</tr>
<tr>
<td>Birth Year: </td>
<td><INPUT TYPE=TEXT NAME=birthyear SIZE="20"></td>
<tr>
<td>City:</td>
<td><INPUT TYPE=TEXT NAME=city SIZE="20"></td>
</tr>
<tr>
<td>State:</td>
<td><select name="state" size="1">
			<option selected value="">State...</option>
			<option value="ZZ">None</option>
			<option value="">-- UNITED STATES --</option>
			<option value="AL">Alabama</option>
			<option value="AK">Alaska</option>
			<option value="AZ">Arizona</option>
			<option value="AR">Arkansas</option>
			<option value="CA">California</option>
			<option value="CO">Colorado</option>
			<option value="CT">Connecticut</option>
			<option value="DE">Delaware</option>
			<option value="FL">Florida</option>
			<option value="GA">Georgia</option>
			<option value="HI">Hawaii</option>
			<option value="ID">Idaho</option>
			<option value="IL">Illinois</option>
			<option value="IN">Indiana</option>
			<option value="IA">Iowa</option>
			<option value="KS">Kansas</option>
			<option value="KY">Kentucky</option>
			<option value="LA">Louisiana</option>
			<option value="ME">Maine</option>
			<option value="MD">Maryland</option>
			<option value="MA">Massachusetts</option>
			<option value="MI">Michigan</option>
			<option value="MN">Minnesota</option>
			<option value="MS">Mississippi</option>
			<option value="MO">Missouri</option>
			<option value="MT">Montana</option>
			<option value="NE">Nebraska</option>
			<option value="NV">Nevada</option>
			<option value="NH">New Hampshire</option>
			<option value="NJ">New Jersey</option>
			<option value="NM">New Mexico</option>
			<option value="NY">New York</option>
			<option value="NC">North Carolina</option>
			<option value="ND">North Dakota</option>
			<option value="OH">Ohio</option>
			<option value="OK">Oklahoma</option>
			<option value="OR">Oregon</option>
			<option value="PA">Pennsylvania</option>
			<option value="RI">Rhode Island</option>
			<option value="SC">South Carolina</option>
			<option value="SD">South Dakota</option>
			<option value="TN">Tennessee</option>
			<option value="TX">Texas</option>
			<option value="UT">Utah</option>
			<option value="VT">Vermont</option>
			<option value="VA">Virginia</option>
			<option value="WA">Washington</option>
			<option value="WV">West Virginia</option>
			<option value="WI">Wisconsin</option>
			<option value="WY">Wyoming</option>
							</select>
                            </td>
                            </tr>
 <tr>
 <td>Profession:</td>
 <td><INPUT TYPE=TEXT NAME=profession SIZE="20"></td>
</tr>
<tr>
<td><br /></td>
</tr>

<tr>
<td></td>
<td>
<INPUT TYPE=SUBMIT value="Register">
</td>
</tr>
</FORM>

</div>
</div>


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